Psychogenic dysphonia: when stress affects the voice

Psychogenic dysphonia is a voice disorder caused by a traumatic experience or a highly intense emotional event.. This is a very specific phenomenon that appears, above all, in the young population.

Having lost a family member, being a victim of aggression or even suffering from a personality disorder are factors behind this clinical condition.

Often, when talking about this type of aphonia of psychological origin, it is common to visualize the classic singer or theater actor who is suddenly blocked and unable to go on stage because he has lost his voice. While it is true that this can appear among many artists, It is a recurring event in any population sector and is almost always motivated by a high level of stress..

Doctors and psychologists talk about how important it is to go to the specialist’s office soon. These hoarseness, if not treated adequately, can lead to more serious infectious processes. We analyze it.

What is psychogenic dysphonia?

Psychogenic dysphonia is a voice disorder in which it can alter or disappear. It is more recurrent in women and for its diagnosis pathologies associated with the larynx and neurological diseases must be ruled out. There should be no organic trigger.

It is very common that the person delays in seeking help from a specialist because they usually assume that this hoarseness is the cause of a cold. However, as the days go by, this problem worsens, and that is when you suspect that there may be something else.

On the other hand, it should be noted that this condition, known in the past, was part of what Sigmund Freud called conversion disorders. They are symptoms in which certain bodily functions fail without an organic cause.

The French neurologist Jean Martin-Charcot treated multiple cases. This explains why psychogenic dysphonia is sometimes called conversion dysphonia today.

How does it manifest?

Voice loss does not appear overnight. In fact, most of the time it doesn’t even go away completely. What the person experiences is slight hoarseness and pain in the muscles of the pharynx.. It’s like she’s screamed for a long time and the voice barely has any tone or sounds any different.

Existing typologies

This type of dysphonia can manifest itself in multiple ways, depending mainly on the triggers. Research work, such as those carried out at Flinders University (Australia), indicates that among voice disorders, those of psychological origin are usually the most complex to treat.

The typologies that exist are the following:

Obsessive dysphonia: appears as a result of obsessive-compulsive disorder.Phonophobia: disorder related to the fear of speaking, either in a specific situation or as a result of a traumatic experience.Vocal Trac: situation in which the person loses their voice as a result of a painful or terrifying experience.Neuroasthenic dysphonia: It presents with hypochondriacal behavior and the persistent fear of losing one’s voice.

Causes of psychogenic dysphonia

After analyzing the different manifestations of this psychological voice disorder, we are able to identify a good range of causes that can explain it.

On the other hand, research from Flinders University speaks of a very specific case:

A very young woman suffered a sexual assault. After that experience, her reaction was to silence what happened. Over time, her voice changed, becoming hoarse and gradually disappearing. That is, traumatic experiences are behind many cases of psychogenic dysphonia. On the other hand, certain personality disorders also explain this condition. Family or interpersonal problems, as well as stressful situations, such as workplace harassment, are another example. On the other hand, there are also cases of psychogenic dysphonia in people who have a high level of responsibilities. Being a caregiver for a sick person is a common trigger.

Beyond hoarseness: how is this voice disorder treated?

It is not a hoarseness or an allergy. Nor is it an alteration that disappears by resting, taking care of the vocal cords or breathing.

Psychogenic dysphonia requires multidisciplinary intervention: an otorhinolaryngologist plus a psychologist specialized in psychogenic disorders.

The attention will always be individualized. In these cases, Each patient always starts from a specific psychological and emotional profile that must be diagnosed and understood.. Treating a person who suffered sexual assault is not the same as treating someone with hypochondria. Combining vocal function therapy with psychotherapy implies that the person becomes aware of their physical and psychological condition to work on both phonation aspects and cognitive and emotional aspects (traumas, obsessions, fears, irrational ideas, etc.).

These clinical conditions are not particularly common. However, when they arise they are a challenge for professionals.

Many times these situations are confused with simple laryngitis until little by little they get worse. The work between speech therapists and psychologists is decisive, as is the patient’s commitment.

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